Detor at One Year: From Implementation to Growing Impact 

Last August, Detor, an APHL-developed intermediary solution that links a hospital’s electronic health records (EHR) system with a public health laboratory’s information management system, made its debut when Orlando Health seamlessly sent a set of newborn screening test orders securely to the Florida Department of Health Bureau of Public Health Laboratories.  

It took less than a second. 

The event was significant in that it marked the first time a healthcare system and a public health laboratory were able to centralize test orders and their results, securely exchanging them in near real time and in each of their preferred data formats. In the world of newborn screening, where the timely detection of certain congenital and metabolic disorders means giving a baby the best chance at a healthy life, fast and accurate data exchange is everything. 

Detor in action

Before Detor, orders and their results were often manually entered, either on paper or onto a computer.  

Besides being time-consuming—time that could be better spent on patient care or laboratory procedures—any number of things could go wrong with the antiquated system. A typo could be made, for example, or information could be incomplete or inadvertently left out. When it comes to something like newborn screening, that kind of error can mean the difference between life and death for an infant. 

Detor, which is funded by the US Centers for Disease Control and Prevention, eliminates this sort of human error. It also eliminates the need for a public health laboratory to build and maintain disparate routes with healthcare partners, and instead, allows it to use this one interface through which any partner can connect. Implementing Detor, which is built on the APHL Informatics Messaging Services (a secure, cloud-based platform), enables public health laboratories and healthcare organizations to plug into an existing infrastructure and take advantage of shared resources, expertise and technology across the health landscape. 

What does that all mean? Turn-around time for critical tests is reduced, patients and their healthcare providers get faster results so appropriate treatment can commence and both laboratories and healthcare systems don’t need to spend valuable time and already-limited resources building and maintaining dozens of different interfaces unique to each health partner.  

One state’s experience

Iowa is what’s referred to as a “hub state,” meaning its state public health laboratory conducts newborn screening for other states, including Alaska.  

Before Alaska’s Fairbanks Memorial Hospital began using Detor last March for newborn screening, things happened the old way: The patient’s information was inputted manually while a test order and a baby’s blood sample took a days-long journey through a courier service to Iowa. While today the sample is still mailed, the patient’s information is now pulled from the EHR (essentially a digital version of a patient’s chart) and a test order is placed through Detor. This gives the lab time to schedule the test and follow up if the sample doesn’t arrive.  

When the lab has completed the tests, the results get uploaded (via Detor) to the patient’s EHR, where they appear in the patient’s chart as soon as they’re available. No one must manually input the information, and everything is accessible to the patient, their primary care physician and any specialists. Thanks to Detor, new parents in Alaska can now get their baby’s test results in an average of six days instead of the previous 12.  

How do you measure a year? 

Since Detor passed those first orders from Orlando Health to Florida’s public health laboratory back in 2024, three additional public health laboratories and 25 healthcare facilities in six states have adopted the technology, with more in the process of onboarding. Hospitals using the platform receive newborn screening test results an average of four days faster and can input data in less than a second, rather than the six minutes of manual data entry per result it took in the past. Public health laboratories also see the time benefit, reducing their data entry time from three minutes per order to just one, a 70% reduction. 

“The impact of Detor has been substantial,” said APHL’s Dari Shirazi, Detor’s program owner. “It has saved significant hours both at the hospital and laboratory by eliminating the need for manual data entry. More importantly, the fact that the results are getting back to hospitals an average of four days faster allows physicians to make informed decisions quicker, improving clinical outcomes.” 

While Detor is currently only being used for newborn screening, other applications are possible. The implementation of Detor for other test orders, including sexually transmitted infections and tuberculosis, is in the works. But expanding Detor’s capacity can only occur with adequate federal funding. In a world where disease containment relies on its fast detection, technologies like Detor are essential. It is only with the fast exchange of accurate data that we can successfully—and quickly—respond to disease threats and better protect the nation’s health.